scholarly journals Massive Pulmonary Hemorrhage from Bronchial Varix

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Michael Agustin ◽  
Scott Shay ◽  
Jose Gonzalez ◽  
Pei Liu ◽  
Nancy Lentz ◽  
...  
Keyword(s):  
Bronchial Artery ◽  
Pulmonary Hemorrhage ◽  
Lung Ventilation ◽  
Massive Hemoptysis ◽  
Sleeve Resection ◽  
Artery Embolization ◽  
Blood Clots ◽  
Pulmonary Disorder ◽  
Life Threatening ◽  
Definitive Management

Bronchial varix is a rare pulmonary disorder which may lead to life-threatening hemorrhage. Diagnosis is difficult because of the subtle abnormalities on radiographic and bronchoscopic examination. We present a case of massive hemoptysis from a bleeding bronchial varix. In the absence of immediate complex endobronchial therapy in the island of Guam, this case was initially managed with nebulized and intravenous tranexamic acid. This was followed by endobronchial blockade of the bleeding airway with endobronchial epinephrine instillation. Selective bronchial artery embolization alleviated the acute-phase bleeding. Prone positioning was initiated due to severe hypoxia after blood clots compromised the patency of bilateral bronchial airways. Prone ventilation was employed for 17 hours for 2 consecutive days with intermittent bronchoscopic forceps extraction of airway blood clots while in the prone position. These maneuvers resulted to improved lung ventilation and oxygenation. The patient underwent bronchial sleeve resection surgery for definitive management.

Life-Threatening Hemoptysis

2020 ◽  
Author(s):  
Himanshu Deshwal ◽  
Ankur Sinha ◽  
Atul C. Mehta
Keyword(s):  
Bronchial Artery ◽  
Vascular Anatomy ◽  
Massive Hemoptysis ◽  
Evidence Based ◽  
Airway Protection ◽  
Artery Embolization ◽  
Life Saving ◽  
Advanced Therapies ◽  
Life Threatening ◽  
And Control

AbstractLife-threatening hemoptysis (LTH) is any amount of hemoptysis that causes significant hemodynamic decompensation or respiratory distress which may lead to death if left untreated. While the amount of hemoptysis that qualifies as massive hemoptysis has continued to be debated, any amount between 100 to 1,000 mL/day is considered significant. Up to 15% cases of hemoptysis are LTH and need urgent life-saving intervention. Understanding of pulmonary vascular anatomy is of paramount importance to manage LTH. The goal of treatment lies in airway protection, appropriate oxygenation, and prevention of exsanguination. Once the airway is stabilized, a quick diagnosis and control of bleeding site is targeted. This chapter highlights current practices and approach to LTH including medical management, bronchoscopic approach, and advanced therapies such as bronchial artery embolization and surgical resection. We review situations, such as bronchiectasis, vascular malformation, diffuse alveolar hemorrhage, and tracheostomy bleed and specific approach to management of these conditions in a systematic and evidence-based manner.

scholarly journals Rasmussen’s Aneurysm, Rare yet Acknowledged Cause of Massive Hemoptysis: Retrospective Review of 16 Cases

2021 ◽  
Vol 36 (2) ◽  
pp. 136-143
Author(s):  
Seungwoo Chung ◽  
I Re Heo ◽  
Tae Hoon Kim ◽  
Sun Mi Ju ◽  
Jung-Wan Yoo ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Conservative Therapy ◽  
Bronchial Artery ◽  
Chest Ct ◽  
Massive Hemoptysis ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Chest Computed Tomography ◽  
Life Threatening ◽  
History Of

Objectives: Rasmussen’s aneurysm may cause life-threatening hemoptysis. We investigated the clinical characteristics and outcomes of patients with hemoptysis and Rasmussen’s aneurysm.Methods: We retrospectively investigated patients who clinically presented with hemoptysis and were diagnosed with a Rasmussen’s aneurysm on spiral chest computed tomography (CT).Results: Our study included 16 patients (men:women, 12:4; mean age, 65.25 ± 13.0 years). Massive hemoptysis was observed in nine patients (56%) and blood-tinged sputum in four patients (25%). Ten patients (62.5%) had a history of pulmonary tuberculosis, and three patients (18.7%) had underlying lung cancer. Chest CT revealed coexisting fungal balls in seven patients (43.7%). Bronchial artery embolization (BAE) was performed in 12 patients (75%). One patient died of uncontrolled massive hemoptysis.Conclusions: Patients with Rasmussen’s aneurysm showed hemoptysis during the course of the disease; however, bleeding can be controlled with conservative therapy and radiological interventions, such as BAE.

scholarly journals Successful Surgical Resection following Bronchial Artery Embolization in a Case of Lung Cancer Complicated with Massive Hemoptysis

2018 ◽  
Vol 11 (1) ◽  
pp. 125-130 ◽  
Author(s):  
Hironori Sadamatsu ◽  
Koichiro Takahashi ◽  
Hiroshi Inoue ◽  
Hitomi Umeguchi ◽  
Satoko Koga ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Surgical Resection ◽  
Bronchial Artery ◽  
Treatment Options ◽  
Massive Hemoptysis ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Lung Cancer Patients ◽  
Resected Tumor ◽  
Life Threatening

Hemoptysis is sometimes observed in lung cancer patients and can be life-threatening. We present a case with severe hemoptysis that was resolved by bronchial artery embolization (BAE) followed by surgery. The presence of necrotic tissue in the majority of the resected tumor and only few cancer cells was presumed to be from loss of bronchial artery blood flow. Although BAE is not a standard therapy for lung cancer, it can be useful and may be considered by physicians as one of the treatment options prior to surgical resection in cases with hemoptysis.

scholarly journals Case Report: - A Case of Pulmonary Aspergilloma

2020 ◽  
Vol 5 (9) ◽  
pp. 828-830
Author(s):  
Yasser Mubarak, MD
Keyword(s):  
Antifungal Agents ◽  
Surgical Intervention ◽  
Bronchial Artery ◽  
Massive Hemoptysis ◽  
Fungus Ball ◽  
Artery Embolization ◽  
Surgical Morbidity ◽  
Pulmonary Aspergillosis ◽  
Life Threatening ◽  
Pulmonary Aspergilloma

Virchowdescribed the pathology of human aspergillosisin 1856. Hinson and colleagues classified pulmonary aspergillosis into allergic, invasive, and saprophytic infections. Saprophytic type colonized in pre-existing lung cavity and produceda fungus ball, or aspergilloma. (4) Pulmonary aspergilloma (fungus ball or Mycetoma) is rare pulmonary infectious disease. Its clinical manifestation includes; chronic cough, fever, dyspnea, chest pain, hemoptysis and others, but it may be asymptomatic. (1)It is a potentially life-threatening disease that is difficult to treat without surgical intervention, which is the treatment of choicein selected cases. It does not respond to antifungal agents alone.(5)In cases of high surgical morbidity and mortality, alternative the rapiesare needed.(3)Bronchial artery embolization can be used to treat massive hemoptysis but is rarely completely effective due to the existence of massive collateral blood vessels.(5)

scholarly journals Bronchial Artery Embolization in Life-Threatening Massive Hemoptysis

2013 ◽  
Vol 15 (12) ◽  
Author(s):  
Hossein Ghanaati ◽  
Ali Shakouri Rad ◽  
Kavous Firouznia ◽  
Amir Hossein Jalali
Keyword(s):  
Bronchial Artery ◽  
Massive Hemoptysis ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Life Threatening

STUDY OF EFFICACY AND SAFETY OF BRONCHIALARTERY EMBOLIZATION IN CONTROLLING HAEMOPTYSIS

2021 ◽  
pp. 36-38
Author(s):  
Jernailsingh Bava ◽  
Vivek Ukirde ◽  
Nitesh Jadhav ◽  
Gokul Kathade
Keyword(s):  
Surgical Resection ◽  
Bronchial Artery ◽  
Treatment Options ◽  
Pulmonary Hemorrhage ◽  
Invasive Procedure ◽  
Massive Hemoptysis ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Recurrence Rates ◽  
Early Management

Hemoptysis can be dened as the coughing of blood or blood tinged sputum derived from the bronchial airways or lung parenchyma as a result of bronchial or pulmonary hemorrhage. Massive hemoptysis is an emergent and life-threatening condition with a broad range of underlying causes. Various treatment options for hemoptysis include conservative medical management, bronchial artery embolization and denitive surgical resection. Surgical resection is not possible in those patients associated with poor pulmonary reserve. Alone conservative management also carries higher risk of mortality rate in these cases. Early management with bronchial artery embolization can signicantly reduce the mortality in these patients. Proper techniques, results, and possible complications of BAE should be taken in mind and the same applies for the characteristics of the various embolic agents used in the procedure. In cases of recurrences, the procedure can be repeated effectively.This study done to know efcacy and safety of bronchial artery embolization in controlling hemoptysis. Study was done in Department of Radiology Lokmanya Tilak Medical College and Lokmanya Tilak Municipal General Hospital Sion Mumbai India over a period of 3 years. With its low recurrence rates and low procedure related complications BAE remains one of the best palliative and minimally invasive procedure for management of patients with hemoptysis including those who are unt to undergo or unwilling for more invasive managements such as surgery

scholarly journals HEMOPTYSIS: HOW TO MANAGE ?

2016 ◽  
Vol 3 (2) ◽  
pp. 47-52
Author(s):  
R S Dhaliwal
Keyword(s):  
Pulmonary Resection ◽  
Bronchial Artery ◽  
Tracheobronchial Tree ◽  
Massive Hemoptysis ◽  
Artery Embolization ◽  
Mortality And Morbidity ◽  
Prompt Treatment ◽  
Important Symptom ◽  
Life Threatening ◽  
Pulmonary Parenchyma

Hemoptysis is the expectoration of blood coming from tracheobronchial tree or pulmonary parenchyma. It is one important symptom which brings the patient to a doctor quickly as it frightens the patient and his family very much. It may be streaky or massive ( more than 600ml in 24 hrs ) which can be dangerous to life. Pulmonary tuberculosis remains number one  cause  of hemoptysis in  developing countries. CT Scan chest and bronchoscopy  can give  most of information in these patients. Massive hemoptysis is life threatening and requires prompt treatment. Number of endobronchial techniques like ice cold saline lavage, balloon tamponade and bronchial artery embolization have been devised to temporarily control hemoptysis. Surgery remains the treatment of choice and pulmonary resection has been the most effective method for control of massive hemoptysis and prevention of recurrent hemoptysis in majority of  patients. Surgical rather than medical  methods reduce  patient's  mortality  rates  due to  massivehemoptysis. Newer technique of physiological lung exclusion2   has given  much better results than standard lungresection for hemoptysis with minimal mortality and morbidity. 

A Novel Technique for the Management of Massive Hemoptysis: The Customized Endobronchial Silicone Blocker

2020 ◽  
Vol 15 (2) ◽  
pp. 142-147
Author(s):  
Ravindra M. Mehta ◽  
Rakesh Godara ◽  
Rajani Surendar Bhat ◽  
Chakravarthi Loknath ◽  
Abhinav Singla
Keyword(s):  
Bronchial Artery ◽  
Case Series ◽  
Rigid Bronchoscopy ◽  
Successful Outcome ◽  
Massive Hemoptysis ◽  
Inclusion Criteria ◽  
Artery Embolization ◽  
Conventional Management ◽  
Immediate Bleeding ◽  
Definitive Management

Objective Massive hemoptysis (MH) has a high mortality rate. Therapeutic options include bronchoscopy for endobronchial lesions, bronchial artery embolization (BAE), and emergency surgery. Scant options exist for patients who are not candidates for these modalities. Culprit bronchial segment occlusion is an option to prevent “spillover flooding → hypoxia.” Applying this concept, we describe a case series of MH control using a novel bronchoscopically inserted customized endobronchial silicone blocker (CESB). We analyzed the safety and efficacy of CESBs in a select subset of patients with MH. Methods Inclusion criteria were patients with MH who were unstable for surgery/BAE, failed BAE, or relatively contraindicated/refused BAE. CESBs were manufactured on-site by modifying silicone stents, inserted using rigid bronchoscopy and reinforced with glue. The CESB was removed after 6 weeks when possible. A successful outcome was defined as immediate bleeding control with no recurrence after removal. Results Over 4.5 years, 13 episodes of MH in 12 patients meeting the criteria specified earlier were treated with CESBs. Seven of 12 patients had tuberculosis, 4 active and 3 inactive. One patient had mucormycosis, 1 post-lobectomy, 1 endobronchial renal cell carcinoma, 1 fibrosing mediastinitis, and 1 patient had metastatic laryngeal Ca. Eight of 12 patients were taken for primary-CESB placement. Four of 12 patients were sent for BAE, which was unsuccessful, and rescue-CESB was done for definitive management. The success rate, as defined earlier, was 92.3%, with no deaths from MH. Conclusions Innovative bronchoscopically inserted CESBs are an effective strategy in MH when patients are unstable or fail conventional management.

Sign in / Sign up

Export Citation Format

Share Document